Treatments

Hematologic, or blood, disorders affect blood cells or the blood proteins in clotting or immune systems.

What It Is

Hematologic, or blood, disorders affect blood cells or the blood proteins in clotting or immune systems. Blood disorders may be suggested by decreases in blood cells - anemia (fewer red blood cells), leucopenia (fewer white blood cells), or thrombocytopenia (fewer platelets). Those with anemia may experience fatigue, shortness of breath, or weakness. Fever and infection may indicate a shortage of white blood cells. Too few platelets can lead to bruising or bleeding.

Other times, an increased number of blood cells causes symptoms - as in thickened blood due to polycythemia (too many red blood cells). In diseases such as multiple myeloma there is increased production of immune-related proteins.

There are also clotting disorders where the blood does not form clots effectively (causing bleeding or bruising) or produces them too easily (leading to increased risk of thrombosis, embolism or stroke).

What to Expect

After a sample is taken, blood is examined in lab tests. In some cases, it may be necessary to examine bone marrow, where blood cells are created.

Complete Blood Count: Using a small drop of blood, the complete blood count (CBC) evaluates red blood cells, white blood cells, and platelets. The CBC checks the number of red blood cells and amount of hemoglobin (which carries oxygen in red blood cells), and looks for abnormally shaped cells. Large numbers of immature white blood cells called blasts may indicate a type of cancer called leukemia. Platelets are counted to measure the blood's ability to clot.

Clotting Tests: Tests such as the prothrombin time (PT) and the partial thromboplastin time (PTT) can show how well platelets function, and measure the clotting factors of specific proteins.

Proteins and Other Substances: Some proteins and other substances can be measured in the blood or urine to look for abnormal proteins or antibodies that may indicate specific disorders or cancers.

Reticulocyte Count: The number of new red blood cells (reticulocytes) is counted to measure the capacity of the bone marrow to produce these cells.

Bone Marrow Exam: Unexplained blood cell abnormalities, either in shape or number, may warrant a bone marrow exam. Two kinds of samples, a bone marrow aspirate and a bone marrow core biopsy, can be taken, usually from the hipbone. Pain is slight with marrow sampling, and the procedure takes just a few minutes.

For an aspirate, the doctor uses a syringe needle to draw a small amount of soft marrow, which is then examined under a microscope and cultured for bacteria, fungi or viruses. Cell proteins and chromosomes can also be analyzed. In many cases, the aspirate alone is needed to make a diagnosis. However, the process breaks up fragile bone marrow, making determination of original cell arrangement difficult. If exact relationships between marrow cells are needed, a biopsy can remove a small core of intact marrow, which can be sliced into thin sections for examination.

Treatment Options

Treatment depends on the severity of the disorder, as well as on the patient's age and overall health. Some drugs can stimulate blood cell production, while steroids or other drugs are used to suppress the immune system. In more severe cases, chemotherapy, radiation, or transplant of bone marrow or allogeneic stem cells may be needed.

To control anemia or bleeding, patients with myelodysplastic syndromes are most often given a transfusion of red blood cells or platelets. Blood clots are usually treated with anticoagulants or other drugs.

Length of treatment [need info from MCA]

Side effects [need info from MCA]